Functional Incontinence Explained
incontinence happens when you can't control your bladder. The bladder is a hollow organ in your pelvic area below and behind your kidneys.
It holds pee until you urinate (pee) and then releases it through tubes of muscles called ureters into your bloodstream.
There are different types of urinary incontinence, including stress and urge incontinence. Mixed incontinence, which is a combination of stress and urge incontinence, is also common.
Causes
Bladder control is a complex system that includes the bladder, kidneys, ureters and urethra. During urination, bladder muscles tighten to move urine into the urethra and release it from the body. When these muscles don’t work correctly, urine can leak.
The bladder is an organ located in the lower abdomen. It’s a tube-shaped bladder that contains urine and is connected to the urethra.
Functional incontinence occurs when a person can’t reach a bathroom quickly enough to urinate. It may be caused by problems with walking or a medical condition.
People with dementia or other types of neurological disorders can have functional incontinence because they have difficulty communicating that they need to urinate or finding a restroom. Other causes include medications that cause grogginess and depression.
The key to treatment is to modify your environment so you can get to and use a toilet more easily and quickly. Some of these changes include making clothing easier to remove or transferring from a wheelchair to a toilet. Scheduled, timed or prompted voiding also can help you stay dry.
Symptoms
Functional incontinence occurs when a person recognizes the need to urinate but cannot access a toilet because of a medical or environmental issue. The goal of treatment is to resolve the underlying cause that caused functional incontinence.
Physical barriers are among the most common issues that lead to functional incontinence, including mobility, dexterity and vision impairments. These can affect a person’s ability to get to the bathroom, adjust their clothing and get onto the toilet in time to pass urine or bowel movements.
Cognitive barriers are also a big factor, including dementia or other mental health conditions that can make you less aware of the need to use the bathroom. This can be an especially serious problem for the elderly, who often have trouble recognizing when they need to go and are therefore more likely to become incontinent.
Other environmental barriers include toilets that are too far away or not accessible for a person’s needs, like stairs or a narrow hallway or doorway. These can be frustrating and lead to accidents.
Treatment
There are several treatments for functional incontinence, depending on the underlying cause. These treatments include behavioural methods, modifying your environment to make it easier to reach the toilet and adjusting your fluid intake.
In addition, it may help to exercise your bladder and pelvic floor muscles. This includes Kegel exercises and biofeedback techniques, which help you to learn how to contract your pelvic muscles effectively.
Some people with functional incontinence can also improve their symptoms with medications such as anticholinergics, which relax your bladder muscle and reduce urine leakage. Examples of this type of medication are oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz) and solifenacin (Vesicare).
Overflow incontinence can be treated by catheterization, which is a soft tube placed into your bladder to drain the fluid that collects in it. It can also be treated with nerve stimulation, which sends electrical pulses to the nerves in your bladder.
Prevention
Urinary incontinence can be embarrassing, so it's important to prevent it. A simple way to do this is by bladder training. This involves scheduling the amount of time between bathroom trips.
This helps you to slow down the urge to urinate and avoid accidents as you try to get to the bathroom. It's also helpful to practice pelvic muscle exercises.
You can also use medical devices to help control incontinence, such as a catheter or urethral insert that drains urine from your urethra. You can also use a vaginal pessary ring that provides pressure to stop leakage.
Functional incontinence can be a challenge for anyone. But it's especially hard
for elderly people because of a variety of factors, such as confusion, dementia or depression.
